Macé Emilie, Caplette Romain, Marre Olivier, Sengupta Abhishek, Chaffiol Antoine, Barbe Peggy, Desrosiers Mélissa, Bamberg Ernst, Sahel Jose-Alain, Picaud Serge, Duebel Jens, Dalkara Deniz
1] INSERM, U968, Paris, France [2] Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France [3] CNRS, UMR_7210, Paris, France.
Department of Biophysical Chemistry, Max Planck Institute of Biophysics, Frankfurt am Main, Germany.
Mol Ther. 2015 Jan;23(1):7-16. doi: 10.1038/mt.2014.154. Epub 2014 Aug 6.
Most inherited retinal dystrophies display progressive photoreceptor cell degeneration leading to severe visual impairment. Optogenetic reactivation of retinal neurons mediated by adeno-associated virus (AAV) gene therapy has the potential to restore vision regardless of patient-specific mutations. The challenge for clinical translatability is to restore a vision as close to natural vision as possible, while using a surgically safe delivery route for the fragile degenerated retina. To preserve the visual processing of the inner retina, we targeted ON bipolar cells, which are still present at late stages of disease. For safe gene delivery, we used a recently engineered AAV variant that can transduce the bipolar cells after injection into the eye's easily accessible vitreous humor. We show that AAV encoding channelrhodopsin under the ON bipolar cell-specific promoter mediates long-term gene delivery restricted to ON-bipolar cells after intravitreal administration. Channelrhodopsin expression in ON bipolar cells leads to restoration of ON and OFF responses at the retinal and cortical levels. Moreover, light-induced locomotory behavior is restored in treated blind mice. Our results support the clinical relevance of a minimally invasive AAV-mediated optogenetic therapy for visual restoration.
大多数遗传性视网膜营养不良表现为进行性光感受器细胞变性,导致严重视力损害。由腺相关病毒(AAV)基因治疗介导的视网膜神经元光遗传学再激活有潜力恢复视力,而不考虑患者特定的突变。临床可转化性面临的挑战是在为脆弱的退化视网膜采用手术安全的递送途径的同时,尽可能恢复接近自然视力的视觉。为了保留视网膜内层的视觉处理功能,我们将目标定位于ON双极细胞,这些细胞在疾病晚期仍然存在。为了实现安全的基因递送,我们使用了一种最近设计的AAV变体,该变体在注入眼睛易于进入的玻璃体液后能够转导双极细胞。我们表明,在ON双极细胞特异性启动子控制下编码通道视紫红质的AAV在玻璃体内给药后介导了仅限于ON双极细胞的长期基因递送。ON双极细胞中通道视紫红质的表达导致视网膜和皮层水平上ON和OFF反应的恢复。此外,在接受治疗的失明小鼠中,光诱导的运动行为得以恢复。我们的结果支持了微创AAV介导的光遗传学疗法用于视觉恢复的临床相关性。